Who Is It For?

17. Acute Soft Tissue Flashcards Preview

There are two main areas that allow abduction in the shoulder: the glenohumeral joint and the abduction of the entire scapula. What is the ratio of the movement of these areas to allow complete abduction?

Circle = the anterolateral ligament (ALL), and there is a small fragment there where the ALL attaches. Apparently this indicates ACL tear. Seriously?

Jen - the ACL tear was likely due to a really great force/impact that proably affected the stabilizing ligaments of the knee (the stabilizng ligaments have to be affected in order for the ACL that is in the middle of the knee to tear). Since those ligaments the tendons holding the knee in place are really strong, they can sometimes rip a piece of bone off rather than tearing themselves. Make sense??

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What is this?

That was a NORMAL ACL appearance on MRI.

This one is a torn ACL on T2-weighted MRI. This image: the patella is to the RIGHT. Note widened, fibrillar appearance of ACL.

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ACL Treatment: what are the options?

No universally accepted approach.

Bracing, PT, Activity Modification, or Reconstruction are all possibilities.

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If you are reconstructing an ACL, what are you goals for surgery? Can you prevent eventual OA in this joint?

Goals = create a more stable knee for pivoting/cutting movements, according to patient's goals.

Probably don't prevent eventual OA in the knee.

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ACL reconstruction: where can you take tendon from in order to reconstruct the ACL?

Often use the middle 1/3 of the patellar tendon. Use bone grafts to attach the two ends of the tendon to the femur and tibia

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ACL reconstruction: how long will it be before the pt is back to normal activity?

6 months to a year, depending on how intense the activity is.

Takes about a year to fully rebuild function and also confidence in the joint.

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ACL injury: risk to males vs females? Why?

Females are at greater risk for this injury because they naturally land from falls in a valgus position.

Can train to land more in a varus or straight position to try to reduce ACL issues.

Pretty sure he said that despite risk to females, males actually injure it ACL more frequently.

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Meninscal injury to the knee: what can it cause? What is the result of removing the meniscus?

Meniniscal injury to knee can cause very limited ROM, because the flap of meniniscus gets in the way like a doorstop.

If remove, immediately feel great and regain ROM. But in 20-30 yrs, they will get OA in that joint.